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Systematic Review and Meta-analysis of Outcome after Mild Traumatic Brain Injury in Older People

Published online by Cambridge University Press:  27 July 2021

Camilla H. Hume Open the ORCID record for Camilla H. Hume [Opens in a new window] ,
Bradley J. Wright  and
Glynda J. Kinsella
Camilla H. Hume*
Affiliation:
School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
Bradley J. Wright
Affiliation:
School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
Glynda J. Kinsella
Affiliation:
Department of Psychology, Caulfield Hospital, Caulfield, Australia
*
*Correspondence and reprint requests to: Camilla H. Hume, Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Melbourne, Bundoora, VIC 3086, Australia. E-mail: C.Hume@latrobe.edu.au
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Abstract

Objective:

Older age is often identified as a risk factor for poor outcome from traumatic brain injury (TBI). However, this relates predominantly to mortality following moderate–severe TBI. It remains unclear whether increasing age exerts risk on the expected recovery from mild TBI (mTBI). In this systematic review of mTBI in older age (60+ years), a focus was to identify outcome through several domains – cognition, psychological health, and life participation.

Methods:

Fourteen studies were identified for review, using PRISMA guidelines. Narrative synthesis is provided for all outcomes, from acute to long-term time points, and a meta-analysis was conducted for data investigating life participation.

Results:

By 3-month follow-up, preliminary findings indicate that older adults continue to experience selective cognitive difficulties, but given the data it is possible these difficulties are due to generalised trauma or preexisting cognitive impairment. In contrast, there is stronger evidence across time points that older adults do not experience elevated levels of psychological distress following injury and endorse fewer psychological symptoms than younger adults. Meta-analysis, based on the Glasgow Outcome Scale at 6 months+ post-injury, indicates that a large proportion (67%; 95% CI 0.569, 0.761) of older adults can achieve good functional recovery, similar to younger adults. Nevertheless, individual studies using alternative life participation measures suggest more mixed rates of recovery.

Conclusions:

Although our initial review suggests some optimism in recovery from mTBI in older age, there is an urgent need for more investigations in this under-researched but growing demographic. This is critical for ensuring adequate health service provision, if needed.

Keywords

Brain concussion (MeSH)mTBIAged (MeSH)Older ageCognition (MeSH)Mental health (MeSH)Social participation (MeSH)Activities of daily living (MeSH)
Type
Critical Review
Information
Journal of the International Neuropsychological Society , Volume 28 , Issue 7 , August 2022 , pp. 736 - 755
Copyright
Copyright © INS. Published by Cambridge University Press, 2021

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